ETHAN JOHN SHAW

UNIVERSITY PARK, PA
NPI1346751823
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: PA  PN271630)
Enumeration Date2017-10-24
Last Update Date2017-10-24
Business Address
ETHAN JOHN SHAW LPN
438 STUDENT HEALTH CTR
UNIVERSITY PARK, PA 16802-2129
Phone number: 814-863-0774
Mailing Address
ETHAN JOHN SHAW LPN
413 ARC RD
WEST DECATUR, PA 16878-8540
Phone number: 814-592-8509
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